Penn Researchers Explore Conflicts of Interest in the Development of Cardiovascular Clinical Practice Guidelines

A new analysis by researchers at the University of Pennsylvania School of Medicine of recent cardiology clinical practice guidelines has found that more than half of the experts involved in the development of these guidelines reported a conflict of interest (COI).

“The extent of COIs in cardiology guideline production had not been well studied up to this point. Our findings that most episodes of guidelines participation involve COIs, and that most individuals involved in producing guidelines report COIs, is a cause for concern,” said corresponding author James N. Kirkpatrick, MD, assistant professor of Medicine and colleagues at Penn. “However, the results of this study also highlight that a strong pool of experts without any COIs are available to direct the clinical practice guideline development process.”

For the analysis, the researchers examined 17 different cardiology guidelines through 2008. Using disclosure lists from the actual guidelines, the researchers cataloged COIs for each participant as receiving a research grant, being on a speaker's bureau and/or receiving honoraria, owning stock, or being a consultant or member of an advisory board. The researchers also cataloged the companies and institutions reported in each disclosure. "Episode" describes one instance of participation in one guideline by one person. "Individual" describes one person who may be involved in multiple episodes.

In the 17 guidelines, the researchers found 651 episodes of participation by 498 individuals. A total of 277 of the 498 individuals (56 percent) reported a COI. On average, each individual participated in 1.31 episodes. Over half of the episodes (365 of 651 [56 percent]) involved a COI. The most common form of COI was consultant/advisory board, followed by research grant, honoraria/speakers' bureau, and stock/other ownership.

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